Physical inactivity during leisure and school time is associated with the presence of common mental disorders in adolescence

Ferreira, Vanessa Roriz; Jardim, Thiago Veiga; Póvoa, Thaís Inácio Rolim; Viana, Ricardo Borges; Sousa, Ana Luiza Lima; Jardim, Paulo César Veiga

doi:10.11606/s1518-8787.2020054001888

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Original Article • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054001888 copy

Physical inactivity during leisure and school time is associated with the presence of common mental disorders in adolescence

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To investigate the association of physical inactivity in leisure and school time with common mental disorders during adolescence.

METHODS:

The sample consisted of 73,399 adolescents (12–17 years old), participants in the Estudo de Riscos Cardiovasculares em Adolescentes (Erica — Study of Cardiovascular Risks in Adolescents). This cross-sectional, national and school-based study was conducted in 2013 and 2014 in Brazilian municipalities with more than 100,000 inhabitants. Leisure time physical activity was categorized according to weekly practice volume, and adolescents were classified as active (≥ 300 minutes/week), inactive (0 minute/week) and insufficiently active (1–299 minutes/week). Sports practice and participation in physical education classes at school were also analyzed. The presence of common mental disorders was assessed based on the general health questionnaire, with a cutoff point greater than or equal to 3. Odds ratios (OR) were estimated using multiple logistic regression.

RESULTS:

The chance of common mental disorders was 16% higher in the group that reported being inactive (0 minute/week) at leisure time (OR = 1.16; 95%CI 1.06 (1.27). The prevalence of common mental disorders was higher among young people who did not practice sports (37.2% vs. 25.9%; OR = 1.14; 95%CI 1.04–1.25) and did not participate in physical education classes at school (39.5% vs. 29.6%; OR = 1.25; 95%CI 1.15–1.36). Insufficient physical activity (1–299 minutes/week) did not increase the OR of common mental disorders. Practicing physical activity during leisure time, regardless of duration and weekly frequency, reduced the chances of common mental disorders in this population by 26%.

CONCLUSIONS:

Physical inactivity during leisure and school time is associated with the presence of common mental disorders in adolescence. The results suggest that sports practice, school physical education and physical activity during leisure time, even without reaching the current recommendation, are related to the mental health of young people.

DESCRIPTORS:
Adolescent; Sedentary Behavior; Mental Disorders; Mental Health; Physical Education and Training

Variables		%
Gender
	Boys	44.6
	Girls	55.4
Age (years)
	12–14	45.9
	15–17	54.1
Skin color
	Black	7.8
	Mixed race	52.5
	White	36.4
	Yellow	2.6
	Indigenous	0.7
Type of school
	Public	78.7
	Private	21.3
Stage of sexual maturation^a a Prepubescent (Tanner stages 1 and 2), pubescent (Tanner stage 3) and postpubescent (Tanner stages 4 and 5).
	Prepubescent	0.5
	Pubescent	62.9
	Postpubescent	36.6
Weight status^b b Classification of nutritional status according to z score of body mass index for age33.
	Underweight	2.9
	Adequate	72.6
	Overweight	16.8
	Obesity	7.7
Common mental disorders
	Yes	31.8
	No	68.2

		Total (n)	With CMD (%)	Gross OR (95%CI)	Adjusted OR^b b Multiple logistic regression model, adjusted for gender, age, type of school, stage of sexual maturation, body mass index, smoking and alcohol consumption. (95%CI)
Leisure time physical activity^c c Practice of any physical activity during leisure time, regardless of modality, duration or weekly frequency.
	No	13,334	38.5	1.00 (reference)	1.00 (reference)
	Yes	60,065	30.4	0.64 (0.58–0.70)^a a p < 0.01.	0.74 (0.66–0.82)^a a p < 0.01.
Leisure time physical activity					1.00
	Active (≥ 300 minutes/week)	32,613	28.4	1.00 (reference)	(reference)
	Insufficiently active (1–299 minutes/week)	19.453	30.4	1.07 (0.95–1.19)	0.92 (0.82–1.03)
	Inactive (0 minute/week)	21,333	38.4	1.58 (1.46–1.69)^a a p < 0.01.	1.16 (1.06–1.27)^a a p < 0.01.
Sports practice^d d Practice of one of the following modalities: athletics, swimming, tennis, wrestling, gymnastics, soccer/futsal, handball, basketball and volleyball.
	Yes	34,932	25.9	1.00 (reference)	1.00 (reference)
	No	38,467	37.2	1.63 (1.52–1.74)^a a p < 0.01.	1.14 (1.04–1.25)^a a p < 0.01.

		Total (n)	With CMD (%)	Gross OR (95%CI)	Adjusted OR^b b Multiple logistic regression model, adjusted for gender, age, type of school, stage of sexual maturation, body mass index, smoking and alcohol consumption. (95%CI)
Participation in physical education classes^c c participation in physical education classes at school at least once per week.
	Yes	56,920	29.6	1.00 (referência)	1.00 (referência)
	No	16,479	39.5	1.56 (1.45–1.68)^a a p < 0.01.	1.25 (1.15–1.36)^a a p < 0.01.
Frequency of physical education at school
	Did not participate	16,479	39.5	1.00 (referência)	1.00 (referência)
	1 time per week	29,791	31.3	0.71 (0.65–0.77)^a a p < 0.01.	0.85 (0.77–0.93)^a a p < 0.01.
	2 times per week	23,929	27.8	0.58 (0.54–0.63)^a a p < 0.01.	0.74 (0.68–0.82)^a a p < 0.01.
	3 times per week	3,200	27.5	0.63 (0.53–0.73)^a a p < 0.01.	0.91 (0.76–1.09)

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[1] Correspondence: Ricardo Borges Viana, Universidade Estadual de Goiás Escola Superior de Educação Física e Fisioterapia do Estado de Goiás Avenida Oeste, Quadra 117, Setor Central, 74075-110 Goiânia, GO, Brasil. E-mail: vianaricardoborges@hotmail.com